38-Inhibitors of bacterial cell wall synthesis Flashcards
Alterations in what structure causes bacterial resistance in cell walls?
a) capsid
b) porin
c) polycascharide
d) surface antigen
b) porin
What explains the varying sensitivity that beta-lactam bacteria have to antibiotics?
a) strength of the capsule
b) affinity for penicillinase binding protein
c) strength of ionic bonding
d) all of the above
b) affinity for penicillinase binding protein
Which is not a beta-lactam drug?
a) Penicillin
b) Cephalosporin
c) Carbanems
d) Monobactam
e) Tetracycline
e) Tetracycline
Amoxicillin, Ampicillin, and Piperacillin are all examples of a _________drug?
a) narrow spectrum
b) penicillinase resistant
c) extended spectrum
c) extended spectrum
piperacillin is also antipseudomonal
Pencillin is…..
a) narrow spectrum
b) penicillinase resistant
c) extended spectrum
a) narrow spectrum
Dicloxacillin and nafcillin…
a) narrow spectrum
b) penicillinase resistant
c) extended spectrum
b) penicillinase resistant
Penicillin can cross the blood brain barrier?
a) true
b) false
b) false
which is not an indication for giving benzathine, a long acting penicillin?
a) syphillis
b) group a strep
c) rheumatic fever prophylaxis
d) cellulitis
d) cellulitis
the aminopenicillins like amoxicillin and ampicillin are good at fighting what type of bacteria?
a) GNCs
b) GPCs
c) Aerobes
d) Anarobes
b) Gram positive cocci
they can fight some enteroccoci and gram negs as well, but not their primary target
You are considering giving an aminopenicillin like amox or amp and want to also cover for the other causes of otitis media such as H.Flu and Mcat (both gram neg cocci) as well as URIs and pneumonia, what drug could you add to cover for those?
Amox + Clavulate (Augmentin)
Amp + Sulbactam (Unasyn)
a pregnant woman is eating lots of cheese, you are worried for Listeria causing meningitis, what single aminopenicillin would you give to cover her for that bug?
Ampicillin
extended spectrum penicillin (combo) for human bites…..
Augmentin or Unasyn
cover everything
Ampicillin, is particularly likely to cause a maculopapular rash in patients with certain viral infections, such as……
Mononucleosis
Epstein Barr virus
pencillins are relatively safe with a low side effect profile…true or false?
true
Piperacillin can fight gram +-, aerobes and anaerobes, but is best against.
a) meningitis
b) diabetic ulcers
c) pseudomonas
d) all of the above
pseudomonas
(piperacillin, ticaracillin are both antipseudomonals)
all renally eliminated
super infection with a penicillin resistant organism will likely be what?
a) CRE
b) C Diff
c) Enterocolitis
d) Bacterial endocarditis
b) C Difficile
any abx can cause it, but clinda definately can
1st gen cephalosporins treat______, and as you go up the generation ladder, they increase coverage for________?
1st gen treats GPC,
subsequent gens treat gram negs.
cephalosporins have less reactions than most drugs, but how are the eliminated?
renally
however, ceftriaxone is excreted in the bile and therefor has a longer halflife
what cephalosporin generation treats klebsiella?
1st generation, like Cephalexin (keflex)
Lyme disease (gram negative) is treated with what generation cephalosporin?
third gen…ceftriaxone
Why should you educate your patients not to drink while on a cephalosporin?
Because the drug + ETOH combo can cause a Disulfiram reaction (the same affects as drinking while on Antabuse….profound n/v)
What is the best drug to give someone with pseudomonas and borderline renal failure (hint: its not a penicillin or cephalosporin)?
Aztreonam (A monbactam)
especially useful for PCN allergic patients with pseudomonas as well.
Thats why we give Piperacillin + Tazobactam (Zosyn) both are good against pseudomonas
what drug if given alongside your primary drug, can inhibit its excretion and boost serum concentrations of the desired drug (will work well with Carbapenams)?
Probenicid (competes for renal excretion)
Carbapenams can INCREASE OR DECREASE seizures thresholds?
Decrease (make it easier to get a seizure)
